Legislative Advocacy Update

Robert C Bernstein, MD, FACC

Advocacy Chair

Virginia Chapter American College of Cardiology

VCACC Congressional and State Legislative Advocacy Update

11/10/2024

ACC Legislative Conf 10/2024:

ACC supported 5 legislative initiatives

1. Short-term Medicare payment reform

No legislation to mitigate medicare provider payment existed as of conference 10/2024

ACC supported Miller-Meeks, et al Letter to Congressional leadership to take action 10/2024

(see 11/2024 House bill HR 10073 in section below)

2. Long-term Medicare payment reform

HR 2474 Strengthening Medicare for Patients and Providers Act

Provides an annual inflationary update to the Medicare Physician Fee Schedule

-Bill introduced House 4/2023.  Referred 4/2023 to two committees.  E&C forwarded to Heath subcommittee 4/2023.  No interval action.

HR 6371/S 4935 Provider Reimbursement Stability Act / Physician Fee Stabilization Act

Increases budget neutrality threshold from $20 million to $53 million

-Bill introduced House 11/2023.  Forwarded to two committees.  Approved House E&C Health subcommittee. Forwarded to full committee 11/2023. No interval action

-Bill introduced Senate 8/2024. Referred to Finance Committee. No interval action.

3. Streaming Prior Authorization Practices

HR 8702/S 4532 Improving Seniors’ Timely Access to Care Act of 2024

Would codify CMS Interoperability and Prior Authorization Rule 1/2024 making it permanent.

Provides mandates for electronic PA, increases insurance company transparency, reduces response times, and creates a pathway to realtime decision making for routinely approved services

-Bill introduced House 6/2024. Referred to two committees 6/2024.  No interval action

-Bill introduced Senate 6/2024.  Referred to Finance Committee 6/2024. No interval action

4. Maintain Critical Telehealth Flexibilities

HR 7623 Telehealth Modernization Act

Extends current telehealth visit PHE provisions for 2 years (does not make permanent)

-Bill introduced 3/2024.  Passed subcommittee on Health unanimously. Full committee ordered reported amended bill to full House unanimously 9/2024.  No interval House action.

HR 1406/S 3021 Sustainable Cardiopulmonary Rehabilitation Services at Home Act

Increases remote access to cardiac and pulmonary rehab for patients with mobility issues or living in rural areas

-Bill introduced in House 3/2023.  Referred to two committees and appropriate subcommittees.  E&C Subcommittee on Health forwarded amended bill to full committee 5/2024.  No interval action.

-Bill introduced in Senate 10/2023.  Referred to Finance Committee.  No interval action.

5. Increase Community Access to AEDS

HR 2370/S 1024 Access to AEDs Act

Authorizes HHS grants to public elementary and high schools for AED purchases, AED and CPR training, maintenance costs.

-Bill introduced in House 3/2023.  Referred to two committees.  Referred to E&C Health Subcommittee 4/2023.  No interval action

-Bill introduced in Senate 3/2023.  Referred to committee.  No interval action.

HR 6829 Cardiomyopathy Health Education, Awareness, and Research and AED Training in the Schools (Hearts) Act

Includes above Access to AEDs Act provisions plus HCM education and research funds.

-Bill passed the House 9/2024.  Referred to Senate 9/2024. Referred to committee.

Post Legislative Conference movement

Short-term Medicare payment reform - interval action post ACC Legislative Conf

HR 10073 Medicare Patient Access and Practice Stabilization Act of 2024

Bill would 1) eliminate pending 2.8% cut to medicare 2025 provider payment; and 2) provide inflationary update equal to 50% of Medicare Economic Index

-Bill introduced in House 10/29/2024.  Referred to two committees.

** Grassroots Action Alert from the ACC is in your inbox **- please submit email to your house representative! **

CMS Medicare Physician Fee Schedule 2025 Final rule

General highlights:

PFS conversion factor is $32.3465 = 2.83% reduction from 2024

PFS reimbursement for cardiovascular services is projected to remain overall flat c/w 2024.

Telemedicine:

Telehealth originating site location to certain rural and underserved location

Audio-only will satisfy interactive telecommunications if 1) patient cannot or will not use video technology. 2) Practitioner must still have audio-video capabilities.

Through 2025 practitioners can still use enrolled practice location instead of home address when providing telehealth services from home.

ASCVD Risk Assessment and Management G Codes:

CMS proposal to create coding and payment for CV medication, BP, and lipid management, and smoking cessation.

Quality Payment Program:

Six new MIPS Value Pathways (MVPs) to be available 2025 performance year.

Revisions to all previously finalized MVPs.

CMS Outpatient Prospective Payment System and Ambulatory Surgery Center 2025 Final Rule

General highlights:

OPPS payment increase 2.9% to hospitals and ASCs meeting quality reporting requirements

No change made to cardiovascular services on Inpt-only and ASC Covered Procedures List

Notably, cardiac ablations were not added to the ASC CPL (happy to provide more detail).

CMS temporarily reassigning some cardiac CT codes to increase payment (almost 2-fold) while claims data reviewed

CMS to separately pay for radiopharmaceuticals meeting a $630/d threshold.

State Advocacy - Update to State legislative letter 10/2024

Update from 9/2024 state legislative recap 9/2024:

VCACC policy proposal to ban noncompete clauses for healthcare providers was approved without dissent at the Medical Society of Virginia House of Delegates 10/2024

Efforts to gain support to create a bill are ongoing with MSV Government Affairs, MSV BOT, and state senate representatives.

Thank you to VCACC legislative delegation participants

Robert C Bernstein, MD FACC

Linda Hart, DNP RN ACNP-BC

Chris Kramer, MD FACC

Pamela Mason, MD FACC

Jacob McAuliffe, MD FIT

Ethne Nance, CEO

Victor Soukoulis, MD PhD FACC

George Vetrovec, MD MACC

Ashley Young, NP

Please reach out with any questions.

VCACC Advocacy Committee

Robert C Bernstein

Daniel F Pauly

Frank Amico

Please contact me with any questions.

Thank you,

Rob

advocacy@vcacc.org